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Waitematā DHB Intensive Care & High Dependency Units

Public Service

Description

The North Shore Hospital Intensive Care Unit and High Dependency Unit provide intensive care and high dependency care for adult patients (>15 years). However, this excludes conditions where tertiary/quaternary input is required, details are listed below:
  • heart, lung and blood vessel surgery is provided by Auckland City Hospital (ICU patients then stay in Cardiothoracic and Vascular ICU)
  • brain surgery, liver/kidney/pancreas transplantation, complex major trauma and some types of liver failure management are provided by Auckland City Hospital (ICU patients then stay in the Department of Critical Care Medicine)
  • burn management is provided by Middlemore Hospital (ICU patients then stay in Middlemore Hospital ICU).

The North Shore Hospital combined ICU/HDU admits patients to the Intensive Care Team. The intensive care patients are the sickest patients in the hospital and have one-to-one nursing. High dependency patients are those who are not as sick but need more specialised medical and nursing input than can be provided on a general ward and may be nursed in a two-to-one ratio.

The multidisciplinary team within ICU/HDU is made up of highly experienced and professional doctors, nurses and allied health staff. The Consultant doctors are those who have specialised in taking care of very ill patients (Intensivists) and Registrar doctors training to be specialists in intensive care, anaesthesia, emergency medicine, internal medicine and surgery. The registered nurses are specialised in intensive care and high dependency nursing. Allied health members include physiotherapists, dietitians, pharmacists, radiographers, occupational therapists, speech language technicians and biomedical technicians.
 

 
What is Intensive Care?
Intensive care is the specialist care given to patients with acute (sudden), potentially reversible, life-threatening diseases. This may include patients who have life-threatening conditions such as a major accident, a severe infection or those recovering from a major operation. Intensive care units may be  divided into two areas; the Intensive Care Unit (ICU) where the sickest patients are cared for, and the High Dependency Unit (HDU) where patients who are not well enough to return to general wards are treated. In some hospitals coronary care patients and other high care areas may be combined within an intensive care area.
 
Intensive Care is staffed by a team of highly experienced and professional doctors and nurses who are supported by other allied healthcare professionals. Specialist doctors trained to look after very ill patients staff the ICU. Most patients requiring intensive care treatment have a nurse allocated to look after them individually.  High Dependency Unit patients may be cared for by a nurse who is also looking after another patient in the HDU. The ICU and HDU also have physiotherapists, dietitians, pharmacists and many other healthcare professionals to help care for these very ill people.
 
What to expect
Much of the value of the Intensive Care Unit comes from the careful monitoring of the progress of a disease and the body’s response to complex treatments. This allows timely adjustment of such treatments. In order to achieve this, many investigations and monitoring processes will occur. It may be necessary at times to perform complex procedures in the ICU, which may be time-consuming and require the Unit to be closed to visitors. 
 
Besides blood tests (see below), monitoring of other body functions is also commonplace. Heart rate and rhythm, blood pressure, oxygen saturation and urine output monitoring are routine. Specific conditions may require other investigations. The changes are monitored and therapy adjusted as a result of the monitoring.

Consultants

Referral Expectations

Patients may be admitted to the Intensive Care Unit/High Dependency Unit from the Emergency Care Centre, a ward, the operating theatre, the Coronary Care Unit or following transfer from another hospital or intensive care unit.

Waitakere Hospital does not have its own Intensive Care Unit or High Dependency Unit, thus patients who require this level of care and do not have conditions for which they need to go to the other Auckland hospitals (see above) are usually admitted to the North Shore Hospital Intensive Care Unit/High Dependency Unit.

North Shore Hospital Intensive Care Service has a Critical Care Outreach Team. This is a 7 day per week service of intensive care nurses experienced in the care of both intensive care and ward patients. The Outreach Team follows up patients who are discharged from the ICU/HDU to other inpatient areas. If a ward team is concerned that a patient is becoming very ill, they can refer to the Outreach Team for clinical review and subsequent involvement of the ICU Medical Team if intensive care or high dependency therapies are required.
 

Procedures / Treatments

  • Cardiovascular (Heart and Circulation) Problems

    A seriously ill patient will often develop problems with their heart and circulation.… More

  • Respiratory Problems

    Breathing (or respiratory) problems occur if the breathing system is unable to provide enough oxygen to the tissues (hypoxia) or remove enough carbon dioxide from the body.… More

  • Renal (Kidney) Problems

    In a patient with kidney (renal) failure, the kidneys are unable to remove wastes and excess fluid from the body.… More

  • Intravenous and Intra-arterial Lines

    Intravenous and intra-arterial lines (tubes inserted into veins and arteries) are often used to allow better monitoring of the patient, repeated pain-free blood testing and delivery of special medications.… More

  • Nasogastric Tube

    A nasogastric tube is a tube inserted into the stomach through the nose.… More

Visiting Hours

During Level 3 Restrictions - COVID 19

Special rules are in place for people wishing to visit Waitematā DHB facilities during the COVID-19 pandemic. These rules are consistent with Government measures that are in place to restrict contact between people and reduce the risk of COVID-19 spreading.

The rules also reflect the vulnerable nature of many of the individuals who access our services and are at high risk of the impacts of COVID-19. They consider the wellbeing of individual patients alongside the wellbeing and safety of the Waitematā DHB community and workforce as a whole.

Visiting the ICU/HDU will only be allowed in exceptional circumstances, (on compassionate grounds), to non-COVID 19 patients only. 

Our staff will ensure that you are kept up to date with your loved one's progress with regular telephone contact.

We recommend that family/friends do not visit around 8:15am to 9:30am or 7:00pm to 8:00pm when handover is occurring. Visiting is usually limited to next-of-kin or close friends, and generally no more than two visitors may be with the patient at a time. Patient care takes priority and visiting may not be possible when some procedures are being undertaken.

A waiting room is next to the ICU/HDU. Vending machines are within a general waiting area near the main lifts and on the ground floor.

Please consult the Charge Nurse before bringing children under the age of 12 years to visit the patient. Children must be supervised at all times.

To reduce the risk of infection, please clean your hands with alcohol gel before and after visiting the patient area. In certain situations, you may need to wear a mask and gown and gloves whilst visiting the patient (these will be provided if necessary). Flowers are not permitted in the patient area as they may be an infection risk.

Website

www.waitematadhb.govt.nz

Contact Details

North Shore Hospital

North Auckland

Freephone 0800 80 93 42 - Waitemata DHB residential areas only
Patient enquiries:
(09) 486 8930

Emergency Department: Open 24 hours / 7 days, Phone (09) 486 8900

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Shakespeare Road
Takapuna
Auckland 0620

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Street Address

Shakespeare Road
Takapuna
Auckland 0620

Postal Address

Private Bag 93503
Takapuna
Auckland 0740

This page was last updated at 11:09AM on May 7, 2020. This information is reviewed and edited by Waitematā DHB Intensive Care & High Dependency Units.